IRIS Acute Flashcards
AKI grade I
Creatinine < 140umol/L
IRIS AKI grade II
141-220umol/L blood creatinine
IRIS AKI grade III
Blood creatinine 221-439umol/L
IRIS AKI grade IV
Blood creatinine 440-880umol/L
IRIS grade V AKI
Blood creatinine >880umol/L.
IRIS AKI subgrading criteria
- Non-oliguric (NO) or oliguric (O)
2. Requiring renal replacement therapy (RRT)
List potential underlying causes for AKI patients
Rule out known causes. 1. Lepto serologogy 2. Urine culture 3. Toxicology (including calcium) 4. Basal cortisol 5. Drug history (Ladies crushed terrifying carrots delightedly) \+ sustained hypotension \+ back pressure \+ vasculitis
Define Acute kidney injury
Abrupt and sustained decrease in GFR
List other diagnostic criteria for AKI
Increase in serum creatinine by >26.4mmol/L from baseline
Increase of serum creatinine by >50% of baseline
Oliguria (<0.5ml/kg/hr) hourly for >6 hours.
What should be monitored in AKI patients.
Body weight. Q8h Systolic blood pressure Electrolytes Chemistry, PCV/TS and smear q24h Urine output q4-6h Blood pH.
Discuss prognosis for AKI patients
60% mortality when considered for all causes.
50% of survivors will have CKI.
Discuss body temperature in AKI patients.
Uraemia alters hypothalamic set point, and uraemic patients are often hypothermia.
A normal body temperature or pyrexia are often significant - assess urine for infection.
What is baseline testing for any AKI patient?
Biochemistry (for azotemia, calcium, hyperphosphatemia and hyperkalemia)
CBC for HCT, platelets, leukocytosis
Urine - sediment and dipstick, USG, culture
Imaging; ultrasound for obstructive disease/pyelectasia, evidence of neoplasia
Why is there metabolic acidosis in acute kidney injury?
- uraemia
- inability to excrete H+
- inability to absorb HCO3
- lactic acidosis
